BACKGROUND: Child neglect is one of the most important aspects of child abuse and has become a serious problem influencing children's development all over the world. Therefore, it is necessary to nderstand the current conditions and influential factors of child neglect and establish effective evaluation methods in China.OBJECTIVE: To investigate the current conditions and influential factors of urban child neglect in Suzhou city.DESIGN: A comparative analysis of sampling survey.SETTING: Department of Children's Health Care, Soochow University Affiliated Children's Hospital.PARTICIPANTS: This study was conducted in one public kindergarten and two private kindergartens of urban areas in Suzhou city between March and October 2003. Totally 370 children (196 boys and 174 girls) aged between 4 to 6 years old without obvious physical and mental diseases were voluntarily investigated, and they had been living with the person that answered the questionnaire regarding to child neglect in China in the recent 1 year. METHODS: Questionnaire regarding to child neglect in China was sent to each volunteer.he questionnaire evaluates the current conditions of child neglect by 20 items of 5 aspects including physical care (buy fruit for child, consider the nutritional need of child, care about the body height and body mass of child), emotional care (chat with child, play and tour with child, encourage child to do the things whatever they can, listen to what the child feels, introduce the child to the guests when they come to your home, let him or her stop immediately when child cries, care about the activities in kindergarten), education care (buy books for child, tell stories to child, recognize and correct the bad behavior of child, answer the questions asked by child seriously), safety care (protections against fire and electricity at home, warn child against matches, knives and other sharp things, teach child how to cross the road) and health care (prepare the common medicine for child at home, urge child to brush teeth, correct the bad posture). The volunteers were asked to answer each question objectively according to the conditions of child within the recent 1 year, and each question should be answered by selecting only one choice (never, occasionally, usually, always), and anyone should not be omitted. Meanwhile,the educational background and occupation of the parents were also investigated.MAIN OUTCOME MEASURES: The general status of child neglect and the effects of different family educational background and occupation of parents on child neglect were observed. RESULTS: Totally 370 questionnaires were sent out, and 370 qualified ones were recollected, the effective rate was 100%. ① In Suzhou city, the children were given better regards and good care in the aspects of education, medicine and safety, but neglects on children's physical and mental care still exists in a few families. ② Families of different educational background could think highly of the medical care, safety and psychical care of children, but neglects on education and emotional development more commonly existed in the families with the educational background under university. ③ All the families with different occupation could think highly of the medical care, safety and physical care of the children, but education and emotional development were better in the cadre families than in the ordinary families.CONCLUSION: In Suzhou city, the children are given better regards and good care in the aspects of education, medicine and safety, but some bad manifestations of child neglect exist in education and emotion, which are associated with the educational background and occupation of the parents.Further studies about the evaluation, prevention and intervention are needed for child neglect in China.

Objective:To study the mechanism of immune tolerance induce by protal venous injection of donor spleen cells on the dog model of renal transplantation.Methods:The donor spleen cells were injected through the protal vein during operation,one week later,renal transplantation was performed.IL-2 and IL-6 were studied by method of ELISA.Results:Level of IL-2 and IL-6 in protal venous group and cyclosporin group was higher than that of control group.There were no difference between protal venous group and cyclosporin group.Conclusion:Immune tolerance could be produced by protal venous injection of donor spleen cells.

Objective To evaluate the role of gamma curve fitting technique of contrast-enhanced ultrasound in quantitative analysis of microcirculation in renal solid lesions. Methods A total of fifty patients with renal parenchyma solid lesions were performed contrast-enhanced ultrasound. The images were analysed by computer with gamma fitting analysis of contrast-enhanced ultrasonic system. The quantitative parameters were obtained by the time-intensity curves, such as ascending slope (a3), descending slope (a2), arrival time (AT), time to peak intensity (TTP), basic intensity (BI), peak intensity, amplification (AMP), area under the curve (AUC), mean transit time (MTT) and perfusion index (PI). The parameters were compared between renal malignant and benign solid lesions. Results Fast-in and fast-out was the main perfusion mode in renal malignant tumors while slow-in and slow-out was found in renal angiomyolipoma (AML). The perfusion modes in renal malignant tumors and renal AML were fast-in and fast-out in 28 cases and 0 case, fast-in and slow-out in 4 cases and 1 case, slow-in and fast-out in 5 cases and 1 case, and slow-in and slow-out in 1 case and 10 cases, respectively. There were significant differences in the quantitative parameters such as a2, AUC and PI between renal malignant tumors and renal AML obtained by the time-intensity curves (P<0.05). Conclusion Gamma fitting analysis of contrast-enhanced ultrasound system can provide quantitative information of microcirculation of renal tumors, which helps to differentiate benign renal tumors from malignant ones.

Objective To investigate the modulation for multidrug resistance cell line K562/A02 us- ing a specific siRNA against mdrl,GST?.Methods siRNA were synthesized targeting the coding region se- quences of mdrl(79～99 nt)and GST?(308～327nt)respectively,and cloned to plasmid pSilence2.1-U6.The cloned products pSilenee-mdr1 and pSilence-GST? were transfected into K562/A02 cells.Expression of mdr1 and GST? mRNA were assayed by SYBR Green Ⅰ real-time PCR.The apoptosis of cell line K562/A02 was examined by Flow cytometry,50% inhibition concentration(IC_(50))of doxorubicin on K562/A02 cell was deter- mined by MTT method.Results The siRNA expression vector against mdr1,GST? mRNA was constructed successfully.After transfected with pSilenee-mdr1,the expression of mdr1 mRNA in K562/A02 in was re- duced 71.5 % compared to the mock transfeetion,from(2.8?1.65)?10~8 copy/?g RNA to(3.9?2.37)?10~7 copy/?g RNA(P

Objective To investigate the influences of gender,age,and body mass index (BMI)on the arterial stiffness in hypertensive patients.Methods A total of 1026 hypertensive patients were enrolled in this study from 6 community health centers in Baoshan District and Shanghai Third People's Hospital.The Related medical histories and carotid-femoral(C-F) pulse wave velocity (PWV) were recorded and PWV were re-tested in 672 patients after 1 year's follow-up.The C-F PWV was analyzed from different group of Gender,age and BMI at baseline and after follow up.Results (1)C-F PWV of the male hypertensive patients were higher than that of female's and the corresponding figures were (13.63 ±3.07)m/s and (12.59±2.85)m/s(P ＜0.01).After one year's follow up,C-F PWV was increased in both male and female with corresponding figures of (14.11 ± 3.58) m/s and (13.51 ± 3.56) m/s (P ＜ 0.05).(2) The C-F PWV was increased with age.The corresponding figures were [(11.11 ± 2.00) m/s for age group 30 ～ 50 years old,(12.73 ± 2.77) m/s for age group ＞ 50 ～ 70 years old,and (14.74 ± 3.29) m/s for age group ＞ 70 years old,all P ＜0.01].After one year's follow-up,C-F PWV of three age groups was increased and the corresponding figures were [(11.36±1.78)m/s(P ＞0.05),(13.39±3.33)m/s(P ＜0.01),and (15.68 ±3.94)m/s(P ＜0.05)].The increased range of C-F PWV (from high to low) was age group ＞ 70,age group ＞ 50 ～70 and age group 30 ～50.(3) C-F PWV of patients with BMI ≥ 24 kg/m2 was significantly lower than that of patients with BMI ＜24 kg/m2 and the corresponding figures were [(12.93 ±2.89)m/s and (13.39 ±3.18)m/s,P ＜0.05].After one year's follow up,C-F PWV was increased and the figures were [(13.54 ± 3.54) rn/s and (14.27±3.61) m/s,respectively(P ＜0.01)].Conclusions Except BMI,gender and age were the important influence factors on arterial stiffness.

BACKGROUND: Fish oil is one of mainly natural resources of n-3 fatty acids, which can inhibit cardiac allograft vasculopathy (CAV) and prolong the survival of cardiac allograft. But, the mechanism is unclear. Recent in vitro data suggested that n-3 fatty acids could inhibit the release of inflammatory transmitter by the activation of peroxisome proliferator-activated receptor-y (PPARy). OBJECTIVE: To test the hypothesis that n-3 fatty acids from fish oil ameliorates CAV development via activating PPARy. METHODS: A total of 6 Lewis rats and 18 Fisher344 rats were randomly selected as heart donors. An additional 24 Lewis rats were randomly and equally divided into 4 groups. In isograft group, heart transplantation was performed among Lewis rats, without any drug. In low-dose fish oil-treated group, F344→Lewis transplantation was performed. At 1 day following surgery, 0.03 mL/kg fish oil was treated by gavage for 8 weeks. In high-dose fish oil-treated group, F344→Lewis transplantation was conducted. At 1 day following surgery, 0.06 mL/kg fish oil was treated by gavage for 8 weeks. In control group, F344→Lawis transplantation was conducted. Cyclosporine A was administrated by gavage for 8 weeks. In the low-dose and high-dose fish oil-treated groups, cyclosporine A (1.5 mg/kg) was given daily by intramuscular injection for 2 weeks following surgery. CAV was evaluated by histological examination. Activity of nuclear factor (NF) k-B and PPARy was assessed in homogenate. Contents of monocyte chemoattractant protein-1 and interferon-inducible protein 10 were measured by enzyme-labeled immunosorbent assay (ELISA). Chemokine receptor CCR2 and CXCR3 expression was determined by real-time quantitative reverse transcription-polymerase chain reaction (RT-PCR). RESULTS AND CONCLUSION: All 24 receptor Lewis rats were survived following surgery. The donor heart could regularly beat at 8 weeks following transplantation. Compared with the isograft group, severe CAV was detected in the control group al 8 weeks. Compared with the control group, CAV was significantly relieved, the activity of PPARy was significantly elevated, the activity of NF k-B was significantly decreased, levels of intragraft monocyte chemoattractant protein-1 and interferon-inducible protein-10 were significantly reduced in the low-dose and high-dose fish oil-treated groups (P < 0.001, P < 0.05), especially in the high-dose fish oil-treated group (P < 0.05). There was no significant difference in expression of chemokine receptors CXCR3 in the low-dose and high-dose fish oil-treated groups and control group. Our results demonstrated that n-3 fatty acids from fish oil can attenuate CAV development, possibly through activating PPARy and subsequently inhibiting the NF-kB activation, the chemokines secretion and its receptor expression in a dose-dependent fashion in rat models.

Objective: To analyze the clinical features and outcomes of cardiac resynchronization therapy (CRT) in patients with dilated-phase hypertrophic cardiomyopathy (DHCM). Methods: A total of 16 DHCM patients received CRT in our hospital from 2007-03 to 2016-01 were retrospectively studied to analyze their clinical features and outcomes. Results: There were 12 male and 4 female patients at the mean age of (53.3±13.5) years. Pre-operative QRS duration of ECG was (158.7±32.2) ms, left ventricular ejection fraction (LVEF) was (33.6±6.3) %, the patient with NYHA class I, II, III and IV were 1, 5, 8 and 2 respectively. 13 patients received new CRT device, 3 received upgraded device and 8 (50%) combining atrial fibrillation (AF). The patients were followed-up for (2.56±2.13) years, 5 of them died including 3 of heart failure, 1 of sudden death and 1 of stroke. At 6 months follow-up time, 7 patients had the response to CRT which was defined by the improvement of NYHA class≥1 and the absolute elevation of LVEF≥5%; NYHA class improved from (2.69±0.79) to (2.38±0.89), P=0.02; LVEF increased from (33.6±6.3) % to (40.03±9.83) %, P=0.01. Conclusion: DHCM patients with CRT indication had the higher incidence to suffer from AF, those were more in patients with traditional pacemaker or ICD upgrading. DHCM patients with CRT had the poor general prognosis, while there was still certain proportion of patients had the response to CRT.

To analyze the predictors and prognosis for super-response to cardiac resynchronization therapy (CRT) in patients with different etiology. Methods: A total of 181 patients received CRT in our hospital from 2012-01 to 2016-01 were enrolled. The patients were divided into 3 groups: Non-response group, n=63, Response group, n=62 and Super-response group, n=56. The patients were followed-up at 6 months after CRT. Results: There were 30.9% (56/181) patients having super-response. Compared with the other 2 groups, Super-response group had more patients with NYHA II-III and less NYHA IV, the patients were with the smaller LAD, LVESD, LVEDD andless patients had CRT-D implantation. The baseline cardiac function was obviously improved at 6 months after CRT in all 3 groups. The basic LVEDD, LVESD, CRT-D implantation, non-ischemic cardiomyopathy (NICM) and NYHA IV were the independent predictors for super-response occurrence. In addition, compared with ischemic cardiomyopathy (ICM), NICM patients had the higher ratio for super-response occurrence (37.6% vs 7.5%), P<0.001. Survival analysis indicated that NICM patients had the lower risk of all cause mortality (HR=0.31, 95% CI 0.14-0.80), cardiac death (HR=0.27, 95% CI 0.09-0.48) and combined endpoints (HR=0.36, 95% CI 0.27-0.78). Conclusion: At baseline condition, the patients with less degree of left ventricular reconstruction, CRT-D implantation, NICM and NYHA IV had more chance to suffer from super-response after CRT. NICM patients had the better response and prognosis to CRT.

Objective To explore the effect of upgrade of dialysate quality on the microinflammation in maintenance haemodialysis (MHD) patients. Methods Fifty-three MHD patients in Kidney Center of the First Affiliated Hospital,Medical College,Zhejiang University in January 2003 were enrolled in the prospectively study.The main end-points were survival at 8 years or weaning from haemodialysis during 8-year period including death, receiving renal transplantation or transferring to peritoneal dialysis.The endotoxin level of dialysate and patients' serum levels of interleukin-6 (IL-6),tumor necrosis factor α (TNF-α),C reaction protein (CRP),and albumin were recorded during the observation period. Results After the upgrade of water management system,endotoxin level of dialysate obviously decreased [(0.046±0.012) EU/ml vs (0.454±0.002) EU/ml,P＜0.01],and serum IL-6 [(3.947±3.624) ng/L vs (13.779±7.106) ng/L,P=0.036],TNF-α [(7.935±3.864) ng/L vs (12.804±8.017) ng/L,P=0.012] as well as CRP [(0.194±0.149) mg/L vs (0.561 ±0.309) mg/L,P＜0.01] decreased significantly,while serum albumin increased [(41.900±6.803) g/L vs (38.140±7.083) g/L,P=0.042].Hemoglobin level did not change significantly after the system upgrade,however,the dose of erythropoietin decreased [(93.0±12.7) U·kg-1·week-1 vs (131.0±10.1) U·kg-1·week-1,P=0.015]. Conclusions The upgrade of central dialysis fluid delivery and water management system by application of double reverse osmosis,high frequency heat disinfection and endotoxin filter can improve the quality of dialysate.Improvement of dialysate quality can ameliorate the microinflammation state of MHD patients.

Objectives:Dose-response effect of nicorandil cardioplegia at various concentrations was studied to optimize its myocardial protective effect.Methods:Forty-eight isolated working rat hearts were divided into 6 groups randomly.They were group A:control (depolarized cardiac arrest with St.Thomas solution No.2),group B,C,E,F and G:hyperpolarized cardiac arrest (nicorandil concentration were 25,50,100,125 and 150μmol/L respectively).The hearts underwent a 120-minute hypothermic arrest (15±1)℃ with cardioplegia (40 ml/kg) and reinfused with cardioplegia (40 ml/kg) at interval of 30 minutes.Mechanical arrest time,cardiac functional recoveries,myocardial content of malondialdehyde (MDA) and ultrastructure were measured.Results:The protective effect of nicorandil cardioplegia was dose-related.Conclusions:The optimal concentration of nicorandil in cardiplegia may be 100μmol/L for myocardial protection.